374 2nd St PLRS22-0156 Plumbing Permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLR522-0156
800 SEMINOLE ROAD ISSUED: 10/19/2022
n v ATLANTIC BEACH, FL 32233 EXPIRES:4/17/2023
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WIRK MYST CINFIRM • • s • • . T! • BUILDIVG
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county,and there may be additional permits required from other
governmental entitles such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
3742ND ST PLUMBING RESIDENTIAL PLUMBING -22 FIXTURES $20000.00
ZONING:TYPE OF REALESTATE BUILDING USE
CONSTRUCTION: NUMBER: SUBDIVISION:
169773 0000 ATLANTIC BEACH
COMPANY: rr •
TDG PLUMBING 4426 LOYS DR JACKSONVILLE FL 32246
• ADDRESS:
TAYLOR ERNEST DEAN 667 GOOD SPRINGS RD BRENTWOOD TN 37027
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE ';220-""000 0 S55 D0
PLUMBING FI%TURES J55-0000-322-1000 22 $154.00
STATE DBPR SURCNA0.GE 455-0000-208-0200 0 $3.14
STATE DCA SURCHARGE 455-OW020806w 0 $2.09
TOTAL:$214.23
Issued Date:10/19/2022 1 of 2
ION
" ALL Plumbing Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 PIRS00--N 5
Phone: (904) 247-5826 Email: Building-Dept0coab.us PERMITMpr el wim X002
JOBADDRESS: 11'.q 'ZAz; JI PROJECTVALUE$ 0,d00, 010
❑NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower S'
Dishwasher 1 Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs uUrinal
Kitchen Sink !_ Vacuum Breakers
LaundryTray Water Connected Appliances
Lavatory )Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler ds)
❑Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
F7 Well '*SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.
Other
Permit becomes void if work does not commence within a 7=..month period or work is suspended or abandoned for six months.
I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances
governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions
of any other state or local law regulation construction or the performance of construction.
Owner NameTA`(LoM DeA'\ Phone Number:
Plumbing Company:TO to 9L%_M_i1'A7 Office Phone: S`fS"TN41 Fax5'1.4'18ST
Co.Address:Uls{14 L_Qi � DQ— City: TA*t state: FL zip: -S'U, i
License Holder:1 Rqy% I A // ate Certification/Registration# G FC-1 YT7d�Z
Notarized Signature of License Holder
The foregou'agjrStrunneiit was acknowledged before me this ad o 20 r 4n the State of Florida,
County-- —�
Signature of Notary Public
TCcwDLESPEBCEe [ ersonally Known OR [ ) Produced Identification
l "= my cohfMlssloNµcc as3178 Type of Identification:
�' '�' E%PIPPS'.Odober 6,2023
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